Tag Archives: cultural immersion

This piece was written and contributed by CFHI participant Carmen Simmons, who was a Medical Student at Meharry Medical College when she participated in the Women’s Reproductive Health program in Puerto Escondido, Mexico in 2018.

When first arriving at the Centro de Salud, I have to admit I was proud of myself. I had managed to find the right colectivo in a mountainous countryside in the quaint town of Río Grande. After exchanging various “Buenos Dias”, I made my way over to partera, traditional midwife,Señora Lucia Zaguilan Mayoral.

At our first meeting, Sra. Lucia patiently listened to my never-ending questions in – let’s be honest – broken Spanish. When she spoke I struggled with the speed of her words. After some compromise on both of our parts, we found a tempo that worked for us to communicate.

Sra. Lucia calls Colonial Villa De Tututepec home and is a Rio Grande native. She has been attending births since she was 13 years old (today she is 63). Coming from a long line of parteras, she started learning as her grandmother’s apprentice. To this day, her family is filled with an impressive variety of healthcare workers.

She has attended conservativelywell over 5,000 births. INCLUDING HER OWN CHILD’S! Yes, that’s right, she delivered her own son. She recounted the story to me while laughing at its ridiculousness. In her last days of pregnancy, she was in the kitchen cooking when her contractions started getting too close for comfort. She can’t exactly remember why no one was home, but nonetheless she had her abundant knowledge of births to comfort her. As calm as anyone could be while delivering her own child, Sra. Lucia guided her son toward the light of life. She even cut the cord herself! By the time her family came back home, they were greeted by a nursing newborn.

During the partera training I was able to witness, Lucia reflected on the immense amount of knowledge her grandmother bestowed onto her. This particular partera training is an annual training co-facilitated by Child Family Health International, local staff and a group of Northwestern students in partnership with the Oaxacan Ministry of Health. As a young girl, Lucia learned many techniques from her grandmother including monitoring her patient’s hair, skin, and eye color and the various methods of moving a baby into the correct position for delivery.

At the partera training, I immediately noticed that all of the women were 60 years or older. I asked her what she thought had changed in the last 20-30 years since she began practicing as a partera to account for this . She comments that she, and others, have noticed a change in attitude with the younger generation. She states that “most young women (under 35) are scared of anything to do with childbirth. Many want cesareans now. And the others are too afraid to learn to be a partera.” The sociopolitical context on the increasing cesarean rate in Mexico is interesting in itself. Approximately 39% of all hospital births in the state of Oaxaca were cesarean births. The World Health Organization states when the cesarean rate goes above 10%, there is no evidence that mortality rates improve.

During my time with Lucia and other parteras, I learned of the integral role that Parteras play in women’s health in Mexico although it seems to be an aging profession. I also learned about the scarcity of resources (financial, equipment, etc.) that the parteras face and overcome daily in their work. I fear that communities will not truly understand the immense importance of their role until there are very few left. My hope is we don’t wait until then, and find a way to revitalize younger generations to strengthen the tradition and empower the existing parteras.

Q. How did you hear about CFHI? What attracted you to the Uganda program?

I heard about CFHI through the study abroad program at Northern Arizona University. CFHI was highly recommended to me. It had always been a passion of mine to volunteer in Africa and experience the culture there—that is what attracted me to the Uganda program.

Q. What were your goals going in to the program? How did CFHI help you in achieving those?

My goals going into the program were really to gain knowledge—whether that be medical or healthcare knowledge, or knowledge of a different culture and how people live, eat, dance, work, etc. in a country completely foreign to me. CFHI helped me accomplish these goals. Their partner organization in Kabale has some very special staff members who were willing to teach me so much. They allowed me to ask any question, explained everything about the people of Uganda and their culture, and made me feel very comfortable.

Q. How did the program impact you?

The program impacted me greatly. It solidified my goals of wanting to go into a healthcare career because I learned how much I love working with patients. I also feel more worldly. I now know so much about a country in Africa where very few Americans travel to. I know about the people, the food, the music, and the languages of Uganda. I saw how amazing the people that live there are, how simply they live, and how much they enjoy life no matter how hard it is. The people there inspired me to live my life like them and to never take anything you have for granted.

Q. What were the highlights of your experience?

I have so many highlights of my time in Uganda. One highlight would be heading down to the clinic everyday, excited to see the staff and looking forward to what I was going to learn or see that day. The relationships that I established with the staff are another highlight. We had amazing conversations and always had so much fun. Other highlights include traveling to villages for outreaches to treat people who could not make it to the main clinic in Kabale, hiking the Muhavura Volcano in Kisoro, and going on a safari in Queen Elizabeth National Park.

Q. How has the program changed your perception of health?

I now understand the diversity of health. Health in Uganda is very different than health in America, yet there are many similarities. There are diseases unique to East Africa that I was able to see and study. There are also differences in the way people are treated and diagnosed for these conditions. The diagnostic tests in Uganda are much more limited, therefore many cases are not solved. Certain conditions and diseases that are treated easily in America are not easily treated in Uganda and are sometimes fatal because people do not have the money to pay for healthcare services or because they wait until that last minute to get checked out.

Q. Who was the most inspiring person you met on the program?

The most inspiring person I met was Allen. He is a medical officer who works under Dr. Anguyo at the KIHEFO clinic and he is the preceptor who I shadowed. He has such a passion to help and treat others. The clinic is very understaffed and Allen wants to go back to school to become more qualified in certain areas such as radiology, so that he can help the clinic even more. While he treated patients, he was so patient and always took the time to explain things to me. Overall, he was a great teacher and such a passionate healthcare worker.

Q. How has your worldview changed?

I knew so little of Uganda and even the continent of Africa before my trip. Africa is not at all like what is portrayed of it on the news. Obviously there are parts with war, disease, and extreme poverty, but there are also amazing things about Africa that I was able to see. I no longer associate one country of Africa with the whole continent. Each country is unique.

Special thanks to Alana D’Onofrio for allowing us to interview her for this post.